[Pyoderma gangrenosum: a rare pathology or an omitted diagnosis?].
Pyoderma gangrenosum is a rare pathology of uncertain etiology. It is an inflammatory dermatosis that causes cutaneous necrosis with a characteristically rapid evolution. No precise diagnosis criteria has been established and pyoderma gangrenosum remains an exclusion diagnosis. In 40 to 50% of the cases, the evolution of pyoderma gangrenosum can be worsened by a nonspecific external stimulus such as a trauma or a surgery. This phenomenon, called pathergy, conduces to avoid any surgical excision of the lesion. However, the diagnosis is often omitted and the rapid evolution of the cutaneous necrosis forces the surgeon to perform a surgical debridement of the wound. It causes a worsening of the lesion. It can have disastrous consequences. We present here three different case reports.
Lê Huu
S
S
Service de chirurgie plastique et reconstructrice, centre hospitalier universitaire vaudois, avenue du Bugnon, Lausanne, Switzerland. serge@lehuu.com
Spertini
F
F
Roggero
P
P
Egloff
D V
DV
Raffoul
W
W
D000328:Adult; D000369:Aged, 80 and over; D003646:Debridement; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007871:Leg Ulcer / Q000150:complications*; D008297:Male; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D012307:Risk Factors; D016896:Treatment Outcome
D005938:Glucocorticoids